Pilowsky Daniel J, Wickramaratne Priya, Poh Ernest, Hernandez Mariely, Batten Lisa A, Flament Martine F, Stewart Jonathan W, Blier Pierre, Weissman Myrna M
Division of Epidemiology at the New York State Psychiatric Institute, USA; Department of Epidemiology at the Mailman School of Public Health at Columbia University, USA; Department of Psychiatry of the College of Physicians and Surgeons at Columbia University, USA.
Division of Epidemiology at the New York State Psychiatric Institute, USA; Department of Psychiatry of the College of Physicians and Surgeons at Columbia University, USA.
J Affect Disord. 2014 Aug;164:107-11. doi: 10.1016/j.jad.2014.04.012. Epub 2014 Apr 18.
Recent findings suggest that remissions of maternal depression are associated with decrease in offspring psychopathology. Little is known about the offspring effects of decrease in paternal depression.
The offspring of married fathers and married mothers were compared. The analysis was restricted to married parents to control for the confounding effect of single parenthood which was more prevalent among depressed mothers. At baseline all parents met criteria for major depressive disorder (MDD), and participated in a 3 month randomized controlled trial to treat depression with a 6 month follow-up. Married parents (N=43) and their children aged 7-17 years (N=78) were assessed independently through direct interviews of children and parents at baseline and followed for 9 months. Child assessors were blind to the clinical status of parents and uninvolved in their treatment.
At baseline, children of depressed fathers, compared to children of depressed mothers, had significantly fewer psychiatric disorders (11% vs. 37%; p=0.012) and less impairment as measured by the Columbia Impairment Scale (6.5 vs. 11.6; p=0.009). Over time, with treatment of parental depression, the prevalence of most child symptoms decreased among children of depressed mothers, but changed little among children of depressed fathers.
The main limitation of the study is the small number of fathers and their offspring included in the study.
Maternal as compared to paternal depression had a greater impact on children. With treatment of parental depression the differential prevalence of child symptoms by parental gender narrowed over time. The clinical implication is that children may benefit from treatment of their depressed parents.
近期研究结果表明,母亲抑郁症状的缓解与后代精神病理学症状的减轻相关。而父亲抑郁症状减轻对后代的影响则鲜为人知。
对已婚父亲和已婚母亲的后代进行比较。分析仅限于已婚父母,以控制单亲家庭的混杂效应,单亲家庭在抑郁母亲中更为普遍。在基线时,所有父母均符合重度抑郁症(MDD)的标准,并参加了为期3个月的随机对照试验以治疗抑郁症,并进行6个月的随访。通过在基线时对孩子和父母进行直接访谈,对已婚父母(N = 43)及其7至17岁的孩子(N = 78)进行独立评估,并随访9个月。儿童评估人员对父母的临床状况不知情,且未参与其治疗。
在基线时,与抑郁母亲的孩子相比,抑郁父亲的孩子患精神疾病的比例显著更低(11% 对37%;p = 0.012),且根据哥伦比亚损伤量表测量的损伤程度也更低(6.5对11.6;p = 0.009)。随着时间的推移,随着父母抑郁症状的治疗,抑郁母亲的孩子中大多数儿童症状的患病率下降,但抑郁父亲的孩子中变化不大。
该研究的主要局限性在于纳入研究的父亲及其后代数量较少。
与父亲抑郁相比,母亲抑郁对孩子的影响更大。随着父母抑郁症状的治疗,按父母性别划分的儿童症状患病率差异随时间缩小。临床意义在于,孩子可能会从其抑郁父母的治疗中受益。